The more I read about antibiotics in ICU the less I seem to understand them. An interesting article published earlier this year by the RENAL investigators revealed that up to 25% of patients on continuous renal replacement in ICU have subtherapeutic trough antibiotic levels. That's not only staggering, but very concerning given we know how important early appropriate antibiotic prescription is to sepsis outcomes. And that's in the context of a clinical trial where everything is so tightly controlled.
Earlier this year I recorded a podcast with Jason Roberts, a clinical pharmacist with the ICU at Royal Brisbane and Women's hospital. It was fascinating to hear his thoughts on this area, and it shows how much we still have to learn about this important topic.
I'm curious to know if anyone is doing drug levels on anything other than vancomycin and gentamicin. Does anyone run continuous infusions to get around this problem? And what about antibiotics in patients getting intermittant haemodialysis in the ICU?
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